Can a Medicare Supplement Insurance plan Help Pay for Home Health Care
Medicare Supplement Insurance plans are designed to work in tandem with Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). Offered by private insurance companies, a Medicare Supplement Insurance plan helps to pay the portion of Medicare-covered services that Medicare does not pay—such as deductibles, coinsurance, and copayments.
Important differences between home care and home health care
Home care refers to help you receive with daily living. For example, you may need assistance with bathing, dressing, light housekeeping, preparing meals, and/or transportation.
Home Care Aides serve a valuable role in providing the kind of non-medical help you need to live at home. Sometimes this is referred to as companion or personal care.
Medicare Part A and Part B generally do not cover home care services. (An exception to this rule may apply if you reside in an area where Medicare PACE plans are available, and you enroll in one.) Because Medicare does not cover home care as a standard benefit, Medicare Supplement Insurance plans generally do not, either.
In contrast, home health care refers to short-term, medically necessary care you may receive for a health condition or multiple conditions.
Registered nurses, certified nurse assistants, occupational, physical or speech therapists typically provide home health care. They may help you with medications, IVs, and durable medical equipment. They may monitor your blood pressure, provide home-based therapy you need, to name just a few care duties.
Medicare provides some benefits for home health care from skilled, medical professionals if you are eligible for benefits. To be eligible for coverage, a doctor must certify that home health care services are medically necessary as part of your treatment plan and that you are homebound. Homebound means that you require assistance to leave your home. You must receive your home health services from a Medicare-approved home health care agency. Information on Medicare-approved home health agencies is available on the Centers for Medicare & Medicaid Services (CMS) website.
Medicare Supplement Insurance plans and home health care coverage
The amount a Medicare Supplement Insurance plan pays for Medicare-covered home health services depends on the home health services you receive and on the Medicare Supplement Insurance plan you purchased.
For most people with Medicare, there are up to eleven (11) Medicare Supplement Insurance plans with standardized benefits, labeled A – N. Massachusetts, Wisconsin and Minnesota have different Medicare Supplement Insurance plan options.
Here’s what you might pay for different home health care services and supplies
- Medically Necessary Skilled Nursing Home Health Services and Medical Supplies: Medicare pays 100% of the Medicare-approved amount. Medicare Supplement Insurance plans pay $0.
These services could include wound care, injections, blood pressure and temperature checks, and physical therapy.
- Durable Medical Equipment (walkers, wheelchairs, oxygen):
Medicare generally pays 80% of the Medicare-approved amount for Medicare-covered medical equipment after you have met your annual Part B deductible.
Any of the following standardized Medicare Supplement Insurance plans will typically pay a portion or all of the Part B coinsurance (20%):
- Medicare Supplement Insurance plan A (100%)
- Medicare Supplement Insurance plan B (100%)*
- Medicare Supplement Insurance plan C (100%)
- Medicare Supplement Insurance plan D (100%)
- Medicare Supplement Insurance Plan F (100%)*
- Medicare Supplement Insurance plan G (100%)
- Medicare Supplement Insurance plan K (50%)
- Medicare Supplement Insurance plan L (75%)
- Medicare Supplement Insurance plan M (100%)
- and Medicare Supplement Insurance plan N (100%)
If you purchased a Medicare Supplement Plan F – High Deductible*, your plan will typically pay the 20% coinsurance, but only after you have paid the annual deductible amount.
*Medicare Supplement Plans C, F, and high-deductible Plan F won’t be available to those who qualify for Medicare on January 1, 2020 or later. But a new high-deductible Plan G might be available in 2020. Plan G is very similar to Plan F, but doesn’t cover the Medicare Part B deductible.
If you already have Plan C or Plan F, you won’t have to give it up. If you want to buy Plan C or Plan F, and you qualified for Medicare before the end of 2019, you may be able to do so.
You can also use find Medicare Supplement Insurance plans in your area by entering your zip code on this page.
The purpose of this communication is the solicitation of insurance. Contact will be made by an insurance agent/producer or insurance company.
Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the Federal Medicare program.